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Details:
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 Ganglionic cysts are fluid filled cysts that are common on the lateral aspect
of the ankle and on the top of the foot. The origin of ganglionic cysts is not
clear. Most clinicians and surgeons believe that ganglionic cysts are
derived from weakened areas of tendon sheath. The weakening in the tendon
sheath allows for herniation of the fluid within the tendon out into the defect.
This herniation is much like what happens when you squeeze a water balloon.
The result is a bubble of fluid enclosed in a defective portion of the balloon
(tendon sheath). This bubble of fluid is what we call a ganglionic cyst.
Ganglionic cysts are also known as Bible cysts or Gideon's cysts. These
names are derived from the historical practice of treating the cyst by rupturing
it with a heavy book. Ganglionic cysts are also sometimes called synovial
cysts. Ganglionic cysts and synovial cysts are very similar in there
presentation and appearance, but differ in their origin. Ganglionic cysts
are derived from tendon sheath while synovial cysts are derived from the lining
of a joint (synovium).
Treatment of Ganglionic Cysts
If asymptomatic, many patients choose to ignore a ganglionic cyst. If
the ganglionic cyst becomes painful, doctors may choose to aspirate the cyst.
Following drainage of the cyst, a crystalline steroid can be infused into the
cyst. Steroid is used in an attempt to scar the pedicle of the cyst to
destroy the communication between the ganglionic cyst and the tendon.
Aspiration of ganglionic cysts with instillation of steroid is a common practice
but only successful in about 50% of cases.
Surgical excision of a ganglionic cyst does have a higher success rate
(85-90%) but does carry with it the cost and potential complications associated
with any surgery. The following steps show the excision of a ganglionic
cyst on the lateral aspect of the foot. This cysts was excised due to the
patient's inability to fit into an enclosed shoe. Depending upon the size
and location of the cyst, most patients can walk on the foot the same day.
This procedure can be completed in approximately 45 minutes and is performed
with either a general anesthetic or local anesthetic with sedation.
Recovery time and return to activities depends upon the success of the surgery
and the extent of the dissection needed to excise the cyst.
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Nomenclature:
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Synovium - Every joint is surrounded by a structure called the joint capsule.
The inner lining of the capsule is a tissue called synovium. Synovium
produces joint fluid that lubricates the joint.
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Anatomy:
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No additional information is available for this topic.
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Biomechanics:
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No additional information is available for this topic.
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Symptoms:
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Many ganglionic cysts are asymptomatic. In cases where ganglionic cysts
do cause pain, we usually find a nerve directly affected by the pressure of the
cyst pushing against the nerve. In some cases, pain may be due to the
inability to fit the cyst into an enclosed shoe.
Ganglionic cysts can vary in their onset and size. Many ganglionic
cysts will grow and shrink in size based upon the volume of fluid within the
cyst and the transfer of that fluid between the cyst and tendon sheath.
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Differential Diagnosis:
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No additional information is available for this topic.
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Products Recommended for Ganglionic Cyst:
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See Also:
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References:
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This article was written by Jeffrey A. Oster, DPM and was last edited on 4/22/08.
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Related Keywords and Search
Terms:
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ganglionic cyst,ganglion,synovial cyst,cyst foot,foot tumor,gideon's cyst,fluid filled cyst,ganglion,foot ganglion |
